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Mississippi’s Exchange has been Rejected

This is a first. The federal government has rejected Mississippi’s plan for a state-based health insurance exchange. This is a result of disagreements between the state’s Governor and Insurance Commissioner. It is still possible for the state to create a partnership exchange.

The state of Mississippi has a unique situation going on in regards to its health insurance exchange. Governor Phil Bryant and Insurance Commissioner Mike Chaney have had disagreements about what kind of exchange their state would have, and over who has the authority to make that decision.

In November of 2012, Commissioner Chaney sent a letter to the Department of Health and Human Services that said Mississippi was going to run a state-based health insurance exchange. Two weeks later, Governor Bryant sent a letter, stating that Mississippi did not want to have a state-based exchange.

In January of 2013, Jim Hood, the Attorney General of Mississippi stated that Commissioner Chaney does have the authority to make the decision about what type of exchange the state would have. He has the authority to run the state’s high-risk insurance pool. Chaney began building a state-based exchange.

Unfortunately, there was a big problem. Although Commissioner Chaney had the authority to create the state-based exchange, and to make decisions about high-risk insurance pools, he lacked the authority over a very important factor – Medicaid. So, the exchange he was building only included subsidized private insurance, (and did not include Medicaid).

Who has the authority to make decisions about Medicaid? That would be Governor Bryant. The Governor was not interested in helping to create a state-based health insurance exchange. The Affordable Care Act requires exchanges to include both private insurance and Medicaid. According to NPR, a spokesman for the Department of Health and Human Services said:

With the Governor’s refusal to work with us or the insurance commissioner, there is no way to coordinate strategy with other agencies he’s in charge of.

The result is that Mississippi’s plan for a state-based health insurance exchange has been rejected by the federal government. At this time, it is unclear exactly what will happen to OneMississippi.com, the Web portal that had been created for the state’s health insurance exchange.

There is still the potential that Mississippi could create a federal and state partnership exchange, and the Department of Health and Human Services is encouraging that choice. There is potential that Mississippi will choose to have an exchange that is run by the federal government, and will create its own state-based exchange that will be exclusively for small businesses.